Individual provider Active NPI

Jessie Lazzari

  • Physical Therapist
  • Daphne, AL
National Provider Identifier
1588044804
Registry record updated Jun 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1-0782 Issued in AL
Practice address
101 Villa Dr
Daphne, AL 36526-4653
Phone
(251) 621-4200
NPI assigned
Jun 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1-0782 AL Primary

Addresses

Primary practice location

101 Villa Dr
Daphne, AL 36526-4653

Mailing address

912 Van Ave
Apt 1536
Daphne, AL 36526-8620
Phone (251) 978-5136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190531000274 AL Practitioner - Physical Therapist in Private Practice 1658604962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of South Alabama College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Encore Rehabilitation, IncGroup PAC ID 3577462126, 182 clinicians

Practice addresses (Care Compare)

1711 N McKenzie St
Foley, AL 36535-2249
Phone (877) 240-1775

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-0782ALMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Encore Rehabilitation, Inc Physical Therapist CurrentSince Apr 18, 2019 Accepting new patients
Encore Rehabilitation, Inc. Physical Therapist CurrentSince Apr 18, 2019 Accepting new patients

Locations

251 Johnston St SE
Ste 300
Decatur, AL 35601
Phone (256) 340-9708

1711 N McKenzie St
Ste 200
Foley, AL 36535

1711 N McKenzie St
Foley, AL 36535
Phone (251) 476-5050

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433203200000",
    "number": "1588044804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 VAN AVE",
            "address_2": "APT 1536",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365268620",
            "telephone_number": "251-978-5136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 VILLA DR",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365264653",
            "telephone_number": "251-621-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZZARI",
        "first_name": "JESSIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-02",
        "last_updated": "2015-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "1-0782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daphne, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.